Leave against medical advice from SNCU of a teaching hospital in Garhwal, Uttarakhand, India

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dc.contributor.authorKumar, Rakeshen_US
dc.date.accessioned2020-09-24T07:42:49Z
dc.date.available2020-09-24T07:42:49Z
dc.date.issued2019-01
dc.description.abstractBackground: Patients who leave against medical advice (LAMA) is a universal problem. Neonates being unable to decide for their own, are dependent on parents for all decisions for their treatment. LAMA is a sensitive issue in neonatology practice with ethical and medico legal ramifications. This study was done to evaluate the factors associated with the decision of LAMA by care givers in our special newborn care unit (SNCU).Methods: This is a retrospective hospital based observational study and was conducted in SNCU of HNB Base Teaching Hospital, Srinagar, Garhwal. Data pertaining to LAMA between 1st August 2017 and 31st July 2018 was retrieved. Information obtained included place of birth, gestational age, weight, diagnoses, duration of hospital stay and reasons for LAMA. Data were entered into a Microsoft Excel Spread Sheet and analyzed using software. Graph Pad Prism v 7.04. Chi-Square test was used to test for significant difference among various groups.Results: Out of 689 neonates admitted in SNCU during the study period, 167 (24.24%) took LAMA. Male to female ratio of 1:1.1. 102 (61%) were inborn and 65 (39%) were out born. Term babies constituted 62.87%. 78.44% neonates were discharged within 7 days of admission. 58 (34.73%) neonates had sepsis and 30 (17.96%) had birth asphyxia. The commonest reason in 25.15% for taking LAMA was to take the neonate to better equipped facility followed by false perception that the baby is well enough to be discharged.Conclusions: Multiple factors contribute for getting a neonate discharged against medical advice. Improvement of infrastructure, training of health care staff for proper counselling, sensitivity and empathy towards neonate and the care givers can decrease the rate of LAMA.en_US
dc.identifier.affiliationsDepartment of Pediatrics, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Garhwal, Uttarakhand, Indiaen_US
dc.identifier.citationKumar Rakesh. Leave against medical advice from SNCU of a teaching hospital in Garhwal, Uttarakhand, India. International Journal of Contemporary Pediatrics. 2019 Jan; 6(1): 176-180en_US
dc.identifier.issn2349-3283
dc.identifier.issn2349-3291
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/203867
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber1en_US
dc.relation.volume6en_US
dc.source.urihttps://dx.doi.org/10.18203/2349-3291.ijcp20185204en_US
dc.subjectDAMAen_US
dc.subjectGarhwalen_US
dc.subjectLAMAen_US
dc.subjectNeonateen_US
dc.subjectSNCUen_US
dc.titleLeave against medical advice from SNCU of a teaching hospital in Garhwal, Uttarakhand, Indiaen_US
dc.typeJournal Articleen_US
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